Redskins Coach Jay Gruden said Monday that Smith was facing a six- to eight-month recovery timeline, which would put Smith comfortably in range of being available for the start of next year’s training camp. But a report later that evening by ESPN’s Adam Schefter — which described the injury as a compound spiral fracture and said Smith faced a “lengthy rehab” — raised doubts about how quickly Smith might be able to return to the field.
The team would not provide further details about the injury, repeating only that Smith suffered a broken tibia and fibula.
A compound fracture refers to a bone puncturing the skin. The spiral description means that a bone was broken in a twisting fashion, as opposed to a straight, clean break.
Alexis Colvin, orthopedic sports medicine surgeon at Mount Sinai Hospital in New York, said a compound break is the more problematic of the two issues.
“It’s now, really, two injuries that he’s recovering from,” Colvin said, speaking generally about those types of injuries. “The broken bone, but also the muscle and the skin being injured around the leg.
“The compound and the spiral parts . . . they’re both telling us the bone is broken in more than just two pieces. Instead of trying to get two pieces of bone to heal together, it may be multiple pieces that you’re trying to get to heal together. Both of those things factor into the healing time.”
There is a greater risk of infection with compound fractures, because of all of the outside debris that could get into the wound once it broke through the skin. The soft tissue must be cleaned out during surgery, Colvin explained, and it sometimes requires going back in for another cleaning with an additional surgery.
Colvin said these types of injuries typically take six weeks before the patient can put any weight on the limb. The rehab process goes from learning how to put weight on the leg, then strengthening it, then preparing for low- to high-impact activities. That can take up to a year, Colvin said.
That isn’t to say Smith’s rehab would also take that long, but there is some question about Smith’s ability to return to his previous level, especially as a player in the latter stages of his career.
Even if the 14-year veteran were never able to return to the field, Smith isn’t facing any major financial concerns: $71 million of his $94 million contract is guaranteed, including for injuries. He is earning $40 million of that this season ($27 million of which came in the form of a signing bonus), $15 million for 2019, and his $16 million for 2020 kicks in on the fifth day of the 2019 league year: March 13.
But the Redskins would face major salary cap ramifications if they needed to move on from Smith due to his injury. Both the $15 million for 2019 and $16 million for 2020 would count against the salary cap in those respective years. If the team were to release Smith before June 1, 2019, it would leave the Redskins with a massive $52.6 million in dead money on the 2019 cap. Their alternative would be to release Smith after June 1, leaving $20.4 million in dead money for 2019 and $32.2 million in 2020.
While the front office will have to consider the long-term consequences of Smith’s injury as his rehab unfolds, and there is hope that Smith can resume his previous place as Washington’s starting quarterback, the team remains in first place in the NFC East and controls its own destiny in terms of returning to the playoffs for the first time since 2015. Colt McCoy is now the starter at quarterback and Gruden has no intentions of letting the team roll over.
“We put a lot of time in and Alex was coming along at a pretty good rate,” Gruden said. “We had a lot of people moving around personnel-wise as far as receivers, running backs, offensive line and he was still playing pretty well. Unfortunately, the injury happened, but it’s not the first time a quarterback has been injured nor will be the last. That’s why you have to have a good backup plan and we feel like we do.”